Abstract
BACKGROUND: Auscultation is a fundamental part of the physical examination, but its utility has been questioned due to the low inter-rater concordance. We therefore sought to evaluate the concordance of the discrimination of lung sound recordings between experienced physiotherapists.
METHODS: Lung sound recordings were selected and validated by an expert panel when Fleiss κ concordance was > 0.75. Eleven recordings were played for subject recognition using a portable computer in their workplace. Results were analyzed using Fleiss κ when looking for concordance between physiotherapists. Univariate regression was performed to determine if there was an association with clinical training, years of experience, academic accomplishment, or university affiliation.
RESULTS: Sixty-nine physiotherapists with a median of 4 years of working experience (interquartile range 2–6 y) completed the study. There was moderate concordance (κ = 0.562; 95% CI 0.462–0.605) for overall lung sound recording discrimination. For continuous and noncontinuous lung sound recordings, discrimination concordance was substantial (κ = 0.63 and κ = 0.76, respectively). A bivariate analysis revealed that years of experience presented an inverse association with stridor recognition.
CONCLUSION: Concordance between physiotherapists in discriminating recorded lung sounds was moderate. The ability to recognize stridor was inversely associated with years of work experience.
Footnotes
- Correspondence: Pablo José Bertrand Navarrete MD, División de Pediatría, Unidad de Enfermedades Respiratorias Pediátricas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 241, Santiago, Chile E-8331010. E-mail: pbertrand{at}med.puc.cl.
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